Therioma is one of the major diseases threatening human health. During 2008, there are about 12.7 million new cancer patients and 7.6 million patients died from cancer worldwide. It is estimated that by 2020, new cancer patients worldwide will increase to 15 million, and the death toll caused by cancer are also rising rapidly all over the world, which may increase to 13.2 million. The prevention and treatment of tumors has become an important research topic in the medical field among countries. Although there have been some antitumor drugs in clinical use, in general, the toxic, serve side effects and drug resistance of these drugs are often observed in clinic, which greatly limit the clinical treatment. Therefore, it is of great significance to develop novel antitumor drugs with high efficiency and low toxicity.
Suppression of cell apoptosis is closely related to the occurrence and development of tumors, which is believed to be one of the important reasons for drug resistance of cancer cells. The study of apoptosis signaling pathway provides a new idea for antitumor therapy, and also provides a new target for developing novel antitumor drugs. In 1995, Akt, also known as protein kinase B, was found as the downstream target of PI3K activated by various growth factors. Akt is at the core position in the PI3K/Akt signaling pathway, and Akt family members have three subtypes including Akt1, Akt2 and Akt3, with more than 80% sequence identity. It is found in the study that the different subtypes of Akt are highly consistent in view of structure and function, except for the expression levels in different tumors. Akt can directly phosphorylate mTOR, Bad and Caspase 9 protein, as well as control Fork Head transcription factor family and NF-κB for further controlling the significant cell biological process in the occurrence and development of tumors, such as transcription, translation, metabolism, apoptosis, angiogenesis, and so on. It is also found in the study that the phenomenon of Akt overexpression or activity disorders exists in most of tumors, and Akt abnormity is closely related to the occurrence and development of these tumors as well as the generated resistance to chemotherapy and radiotherapy. It has been proved that by vivo and in vitro pharmacological experiments that Akt inhibitors can promote programmed death of cancer cells. Therefore, Akt has attracted increasing attention as a potential antitumor target.
Akt inhibitors being in clinical research can be classified into: ATP-competitive inhibitors such as AZD5363, GSK-2110183 (afuresertib), GDC-0068 (Ipatasertib); allosteric inhibitors such as MK-2206; pH-domain binding inhibitors such as Perifosine. GSK-2110183 is an oral Akt inhibitor developed by GSK, and the single-drug thereof exhibits good safety and clinical activity against hematologic malignancies (including multiple myeloma), which is currently in phase II clinical trials. GDC-0068 is a highly selective pan-Akt inhibitor, the drug combination thereof with docetaxel or mFOLFOX-6 is well-tolerated in patients suffered from advanced solid tumors and exhibits preliminary signs of anti-tumor activity, and the dose-escalation trial thereof is still in clinical phase II. MK2206 is a 2,3-diphenyl quinoxalines derivative, which is currently in clinical phase II for the treatment of many kinds of cancer, such as gastric cancer, breast cancer etc. The clinical datas of above compounds confirm that the treatment strategy has good selectivity and improved tumor sensibility to chemotherapy and radiotherapy. Therefore, the development of novel Akt inhibitors is expected to provide clinical medicine with new therapeutic mechanism for tumor therapy.